It has nothing to do with the states. The incentive comes from a federal tax deduction applied to the individual medical practitioners for charitable work in an amount up to 10% of their annual income. The state is never involved, unless I missed something.
Seriously? THATS how the plan pays for the uninsured and uninsurable? A voluntary option to take 10% of their income, which will no longer include young healthy people, and apply it to taxes that they're probably not paying anyway?
You don't think they can make more money NOT booting dying cancer patients off their plans, not accepting people with pre existing conditions, and not insuring the poor? What happens when no one can operate like that?
I realize we play a game where people can throw fireballs from their fingers but paying for the poor with a 10% off coupon is an unbelievable fantasy, not a policy.
It absolutely makes sense for companies to do so.
it does not. Your theoretical ideas about what makes sense for businesses to do does not trump objective evidence that they are not doing this.
Allowing them to operate in any state without having to become licensed in each state where they want to do business opens up a new avenue of (relatively) quickly entering a market where they were previously unable to go.
It also allows them to defraud, steal from, and abandon people with impunity by incorporating in a PO box in delaware if new jersey can't yank their license for defrauding its citizens.
In an age where distance is a non-factor in being able to engage in business transactions, "setting up an office" is low on the totem pole and learning state laws is an inherent part of the business anyway. It adds no major complexities and instead frees previously isolated companies to compete across state lines.
Health care coverage does not work this way. You have to deal with individual doctors offices. Those offices need to be near their sick people. Those offices are not a portable good. And you cannot leave anyone uncovered. You need to know who you're working with and that is incredibly difficult to do from 4 states away.
Now whether or not that was a major issue before, I can't say as I haven't bothered to do much digging since as I previously mentioned, Rand's proposal was DoA. That's a separate issue though.
Of course it's DOA. It doesn't actually cover anyone. Like most libertarian policies it relies on "and then the market fixes everything" and "this will suddenly not cost money" the same way a badly written play relies on "and then the fairy made everything better"